Diagnostic pressure application instrument



1952 c. w; SMITH 2,619,599

DIAGNOSTIC PRESSURE APPLICATION INSTRUMENT Filed Feb. 27. 1952 INVENTORC/l/MLES M6 JM/n/ BY Wv Maw ATTORNEYJ Patented Nov. 25, v 1952DI-AGN'OSTIG- PRESSURE APPLICATION INSTRUMENT CharlesW. Smith, Glenside,Pa.

Application February 27, 1952, SerialN'o. 273L613 9 Claims.

, Th sinrention rela es to an improved devi e fo n lac osconicor Xianphoto raphic xainin, io i e body, and. pa t c lar y o, an n trumentiq hesed'br physicians, oe tseno i sfr dioloa sts an e hnicians e appl cationof pressure to the body tissues during fluoroscopic examination and Xray. photography.

' Influoroscopic and X-ray examination of the bodyfandjparticularly inexaminationof the, gas,- tr "'ntestional tract it is desirable that. thephysicianbe able to. apply a localized pressure to the'abdomen'todisplace organs and tissues which imay overlie and obscur the particularpart of the gastrc-intestinal tract which, in the opinion of thephysician, is the site, of the pathology.

It is the primary object of my invention to provide an improvedinstrument which can be manipulated by the physician to apply such localpressure to any particular part of the abdomen.

It is afurther object of'my invention to provide an instrument which canbe moved from place to place beneath the patient when in a proneposition, which can be positioned in the desired location readily byfluoroscopic examination and by means ofwhich varying degrees ofpressure may bebroughtto bear on the body of the patientunderexamination.

Another object of" my invention is to provide a pressure applicationinstrument which can be easily-sterilized without damage to any of theparts.

It isa further object of my invention to provide an instrument of thecharacter described which canbe manipulated by the physicianwithoutdanger of exposure of the hands of the operator to the X-rays bymeans of which the examination and photographs are made.

I have illustrated my device in the preferred form of" the accompanyingdrawings wherein:

Figure 1 is a plan view of the instrument;

Figure 2 is a side elevation of the instrument showing the distensiblemember thereof in inflated-positionin dot and dash line;

Figure 3 is'an enlarged view with certain parts partiallybroken away;

Figure 4 is a section taken on the line 44' of Figure 3; and

Figure 5 isa section taken on the line 5-5 of Figure 1.

The principal parts of'the instrument are the housing 6, handle I,distensible member 8, X- ray opaque ring 9, tube [0, flexible bulb H andvalve; l2.

The most practicalway to us the device is 2. to place the patient tobeexamlned ina prone or belly-down position onthe X-ray table with thehousing 6 of" the device between the patient and the table, near thearea to be examined, with the open face of thehousingupward. Inthefollowing description it willybe assumed that: the inst-ru-ment isbeing used in that manner.

The housing 6 in the particular embodiment illustratedis made of -amaterial having good tensile strength and oi low atomic weight; toreduceor eliminate opacity-to X'-rays. I have found that methyl methacrylate;whichmaybe purchasedunder the trade name lexi'glas is an excellentmaterial for thepurpose. Othersuit ab-le materials will occur --to-thoseskilled-inthe art.

The handle I of the instrumentmay beintegral with the housing, asillustrated on itmay be a'separatemember; Ineither case it should belong enough to permit the operator to move the housing about beneath thepatient without exposing his hands to X-ray bombardment. The end of thehandle tobe grasped by the operator is advantageously curved upwardlyfromthegeneral plane of the instrument, (as shown in Figur 2) in orderto permit the operator; whomay be wearing thick lead-rubber gloves, tohold the bottom of the housing nat on the tablewhen movin it about underthe patient.

The housing 6 proper may be circular, as-i-il-ustrated, and has aflatupper faceplate i3 and a lower-faceplate it having an upstandingflange I 5 around the edge which engagestheupperplate i3 and spaces itfrom the lowerplate. The upper plate 13 has a central circular openingit of smaller diameter than the inside diameter of the flanged portionof the lower plate M thus providing an overhang and forming an annulargroove or chamber within and around the housing at the edge thereof.

A ring member 9 is embedded in the plate 6 adjacent the edge of theopening It: This ring is made of lead or-some other material which isrelatively opaque to X-rays and when the instrument is in use underobservation by fluoroscope th circular outline of the opening 46'' willbe indicated by the ring and the housing can be moved about beneath thepatient until the opening it is inthe desired position. It-will-beunderstood that the ring; 9 can be embedded in the lower plate I4 ifdesired, so long as it is located'to ins d-icate theposition of opening[6.

It should also be pointed out that while the housing is advantageouslymade of a material which is translucent to X-rays, it could be made ofan X-ray opaque material provided the lower face is translucent toX-rays below the opening in the upper face.

The handle I is provided with a passage I? which extends from the end ofthe handle to the housing and opens into the annular chamber between theupper and lower face plates. If desired, removable plate member i8 maybe secured to the upper face of the handl by means of screws 19 and whenthis plate is removed the passage 11 in the handle is accessible.

In the form of device shown in the drawings the distensible member is aflat circular airtight rubber bladder 8. The diameter of the bladderwhen uninflated should be slightly less than the inside diameter of thering formed by the flange l and considerably greater than the diameterof the opening IB. Thus when the bladder is inserted in the housing theoutside edge thereof will lie under the overhanging portion of the upperplate 13 and when the bladder is inflated this overhanging portion ofplate l3 will engage the edge of the bladder and hold it in the housing.

The "bladder 8 has a tubular extension 8a extending into the passage [1,the end of the tubular extension lying under the removable plate l8. Theend of the tubular extension Ba is connected to a nipple 28 made ofglass, metal or some other hard material. The rubber tube It isconnected to the other end of the nipple and extends in the passage H tothe end of the handle when it is connected to one side of a check valvel2, mounted in the end of the handle. The other side of the check valveis connected to the flexible bulb II. By the construction just describedit will be seen that the bladder 8 may be easily removed from theinstrument by removing the plate It and disconnecting the tubularextension from the nipple. The bladder can then be pulled through theopening in the housing. Conversely it is equally easy to insert a newbladder in the instrument when needed. In case the handle is notprovided with a removable plate, the tubular extension 811 of thebladder would extend to the end of the handle.

The check valve is of a usual type and when the knurled head is screweddown squeezing of the bulb ll will force air through the passages tolift the spring held valve 2| off its seat to perwit the air to flow tothe bladder. When the bulb is released the spring will force the valveto its seat to prevent the air from flowing from the bladder. When theknurled head is unscrewed, the port 22 is uncovered thus permitting theair to escape from the bladder.

From a practical point of view I believe the use of an airtight rubberbladder as the distensible member is preferable but it is pointed outthat it would be possible to use a single sheet of rubber mounted belowthe opening in the upper face in airtight connection to the housing withan airtight passage in the handle leading to the under side of thesheet.

The instrument is preferably used in the following manner: The patientis placed in prone position on the X-ray table with housing, opening up,between the patient and the table and near the part of the abdomen inwhich the pathology is suspected. The fluoroscopic examination is thenbegun and the physician guides the instrument to the part of the abdomenwherein he, by training, seeks pathology. When the opaque ring isobserved to be in proper location to surround the suspected area,pressure is then 4 applied to the body by pumping air into the bladderto distend it through the opening in the housing and as the pressure isapplied the overlying tissue and body parts, some of which may be bariumsulphate filled will be compressed or pushed aside until the physicianis able to clearly visualize the particular site in which he isinterested. The degree of distention of the bladder can be regulated bypumping air into or releasing air from the bladder until best visibilityof the afiected site is secured and the exposure of the X-ray film isthen made.

The housing is so designed as to give it ample surface bearing on theX-ray table. The flat underface gives good frictional engagement withthe table and prevents accidental slipping. The material being anon-abrasive plastic prevents scratching of the surface of the X-raytable which is common when metallic instruments are used on the tabletop. The handle is sufiicient- -ly long to enable the physician to movethe housabout readily without exposing his hands to X-ray bombardmentand the curved and grooved handle grip is high enough to allow theoperator to grasp the handle easily even when his hands are encased inheavy-lead-rubber gloves.

A particular advantage of the use of the removable rubber bladder in theinstrument is that the bladder, tubes and associated parts can be takenout and Washed in an antiseptic or otherwise sterilized if theinstrument should be soiled in use. The housing and handle likewise canmore readily be sterilized when the bladder, tubes, etc. are removed.

I claim:

1. A pressure application device for diagnostic examination of the bodycomprising a substantially flat housing member having an opening in aface thereof, the other face of said housing being transparent to X-raysat least in the area opposite said opening, a handle member attached tothe housing whereby the housing may be moved by the operator withrelation to the body under examination without exposure of the hands ofthe operator to the X-rays, a distensible member extending across saidopening, a fluid passage associated with said handle leading into saidhousing and means to supply fluid under pressure to said passage wherebysaid distensible member may be distended through the opening in thehousing by the fluid pressure to apply pressure to the part of the bodyadjacent the opemng. V

2. A device according to claim 1 wherein the housing has an X--rayopaque section outlining the opening in the housing.

3. A device according to claim 1 wherein the distensible member consistsof an air-tight bladder connected to the fluid supply pass-ageassociated with the handle.

4. A pressure application device for diagnostic examination of the bodycomprising a substantially flat housing member transparent to X-rays andhaving an opening in a face thereof, a handle member attached to thehousing whereby the housing may be moved by the operator with relation'to the body under examination without exposure of the handle of theoperator to the X-rays, a distensible member extending across saidopening, a fluid passage associated with said handle leading into saidhousing and means to supply fluid under pressure to said passage wherebysaid distensible member may be distended through the opening in thehousing by the fluid pressure to apply pressure to the part of the bodyadjacent the opening.

5. A device according to claim 4 wherein the hOuSing has an X-ray opaquesection outlining the opening in the housing.

6. A device according to claim 4 wherein the distensible member consistsof an air-tight bladder connected to the fluid supply passage associated with the handle.

7 A pressure application device for diagnostic examination of the bodycomprising a substantially fiat housing member transparent to X-rays andhaving an opening in a face thereof, a distensible bladder lying beneathand extending across said opening, a handle member attached to thehousing whereby the housing may be moved by the operator in relation tothe body under examination without exposure of the hands of the operatorto the X-rays, a passage in said handle leading into the housing, a tubein said passage connected at one end to the bladder and a flexible bulbassociated with the tube to pump air therethrough into the bladderwhereby said bladder may be distended through the opening in the housingto apply pressure to the part of the body lying above the opening.

8. A pressure application device for diagnostic examination of the bodycomprising a substantially flat housing member transparent to X-rays andhaving an opening in a face thereof, a distensible bladder lying beneathand extending across said opening, a handle member attached to thehousing whereby the housing may be moved by the operator in relation tothe body under examination without exposure of the hands of the operatorto the X-rays, a passage in said handle leading into the housing, a tubein said passage connected at one end to the bladder, a flexible bulbassociated with the tube to pump air therethrough into the bladderwhereby said bladder may be distended through the opening in the housingto apply pressure to the part of the body lying above the open ng, and acheck Valve associated with said tube to prevent escape of air from thebladder.

9. A pressure application device for diagnostic examination of the bodycomprising a substantially fiat circular housing member transparent toX-rays having upper and lower face plates with an opening in one of saidplates, a substantially circular removable distensible bladder lyingbetween said plates, the diameter of the bladder, when uninflated, beinggreater than the diameter of said opening, a handle member attached tothe housing whereby the housing may be moved by the operator in relationto the body under examination without exposure of the hands of theoperator to the X-rays, a passage associated with said handle leadinginto the housing, a tube in said passage connected at one end to thebladder and means associated with the tube to force air therethroughinto the bladder whereby said bladder may be distended through theopening in the housing to apply pressure to the part of the body lyingabove the opening.

CHARLES W. SMITH.

No references cited.

